Limitations of clinical studies evaluating tertiary hyperalgesia

Editor—Shin and colleagues¹ suggested that magnesium sulphate attenuates increased pain intensity at sites remote from the surgical site (tertiary hyperalgesia), based on the observation of reduced pain in a magnesium-administered group vs controls after a second total knee arthroplasty (TKA) during staged bilateral total knee arthroplasty. This may serve as a basis for further studies of tertiary hyperalgesia, a topic that has not been studied extensively to date. Potential confounding factors or possible misinterpretations associated with this study should be discussed to enhance its influence on future studies.

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